Primary Health Need

What is a Primary Health Need?

In order to qualify for NHS Continuing Healthcare Funding (CHC), an individual needs to establish that they have a ‘Primary Health Need’ (also called a primary healthcare need or primary need for healthcare)

The National Framework for NHS Continuing Healthcare and NHS-funded nursing care defines a primary healthcare need as follows:

An individual has a primary health need if, having taken account of all their needs (following completion of the Decision Support Tool), it can be said that the main aspects or majority part of the care they require is focused on addressing and/or preventing health needs. Having a primary health need is not about the reason why an individual requires care or support, nor is it based on their diagnosis; it is about the level and type of their overall actual day-to-day care needs taken in their totality.

The Primary Health Need Test

In order to establish whether an individual has a Primary Health Need, you need to look at the totality of all their relevant needs and how they interact. Once the 12 domains of care have been completed on the Decision Support Tool, the Primary Health Need ‘test’ is then applied. These are the four “Key Characteristics” of nature, intensity, complexity and unpredictability. The Characteristics help to weigh whether the majority of care interventions are aimed at meeting health or social care needs. 

Broadly speaking, social care is assistance to do the things we all do every day – getting up, having a wash, getting dressed, going to the toilet, eating and drinking, moving around, keeping our environment clean and tidy, maintaining social relationships. This is what the NHS and Social Services describe as the “activities of daily living” or “ADL”. For the purposes of CHC assessments, even if a person is totally dependent on others to meet all their ADL, that would still be deemed as social care, unless the interventions required are complex (skilled), intense (labour/time consuming) or unpredictable (rapidly fluctuating). 

Often, the dividing line is very narrow and subjective but outcome will determine who pays the cost of care – the individual or the NHS! 

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We felt more confident going into the review process with Farley Dwek on our side. After they attended the assessment meeting with us we secured the funding and we continue to save on the astronomical care home fees that we might otherwise have had to pay.

Edward Battersby

The service I have received from Andrew Farley for a Continuing Healthcare Funding claim for my mother has been excellent. The initial contact with Andrew gave me a clear picture of the process, outlining timescales and explaining the stages that I would have to go through to achieve a successful outcome.

Mrs P

We would thoroughly recommend Farley Dwek as an organisation and Debbie Payton in particular. We feel that all that she has achieved on behalf of my father is worth every penny and we believe we could not have got this outcome without her. We cannot thank Debbie enough.

Rachel W

I feel like the presence of Farley Dwek in the process was the key factor in our family securing the funding and saving £1,400 per week in care home fees for the BUPA hospital that we had chosen. To say we are pleased with Farley Dwek is an understatement. We’ve been absolutely delighted with everything the team has done and would recommend any family in the same circumstances speak directly to them to give them the best chance of getting the funding.

Mr Barrow

Without Farley Dwek's encouragement and perseverance, I don’t think that I would have proceeded with the claim, nor would it have resulted in such a successful outcome without their professional input at every stage. Their attention to detail, care and support throughout this process has been exemplary.

Ronald

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